Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario
Objective: Non-medical prescription opioid use (NMPOU) is a major health problem in North America and increasingly prevalent among First Nations people. More than 50% of many Nishnawbe Aski Nation communities in northern Ontario report NMPOU, resulting in extensive health and social problems. Opioid...
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Waakebiness-Bryce Institute for Indigenous Health
2013
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ftunitorontoojs:oai:jps.library.utoronto.ca:article/29021 2023-05-15T16:14:52+02:00 Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario Katt, Mae Chase, Claudette Samokhvalov, Andriy V. Argento, Elena Rehm, Jürgen Fischer, Benedikt 2013-06-09 application/pdf https://jps.library.utoronto.ca/index.php/ijih/article/view/29021 https://doi.org/10.3138/ijih.v9i1.29021 eng eng Waakebiness-Bryce Institute for Indigenous Health https://jps.library.utoronto.ca/index.php/ijih/article/view/29021/23838 https://jps.library.utoronto.ca/index.php/ijih/article/view/29021 doi:10.3138/ijih.v9i1.29021 Copyright (c) 2017 International Journal of Indigenous Health International Journal of Indigenous Health; Vol 9 No 1 (2012): Journal of Aboriginal Health; 52-59 2291-9376 2291-9368 10.3138/ijih.v9i1 Aboriginal health addiction community-based treatment prescription opioids opioid substitution treatment info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 2013 ftunitorontoojs https://doi.org/10.3138/ijih.v9i1.29021 https://doi.org/10.3138/ijih.v9i1 2020-12-01T10:53:32Z Objective: Non-medical prescription opioid use (NMPOU) is a major health problem in North America and increasingly prevalent among First Nations people. More than 50% of many Nishnawbe Aski Nation communities in northern Ontario report NMPOU, resulting in extensive health and social problems. Opioid substitution therapy (OST) is the most effective treatment for opioid dependence yet is unavailable in remote First Nations communities. Suboxone (buprenorphine and naloxone) specifically has reasonably good treatment outcomes for prescription opioid (PO) dependence. A pilot study examining the feasibility and outcomes of a community-based Suboxone taper-to-low-dose-maintenance program for PO-dependent adults was conducted in a small NAN community as a treatment option for this particular setting.Design: Participants (N = 22, ages 16–48 years) were gradually stabilized on and tapered off Suboxone (provided on an outpatient and directly-observed basis) over a 30-day period. Low dose maintenance was offered post-taper to patients with continued craving and relapse risk; community-based aftercare was provided to all participants. Results: Of 22 participants, 21 (95%) completed the taper phase of the program. Fifteen (88%) of 17 participants tested by urine toxicology screening had no evidence of PO use on day 30. No adverse side effects were observed. All but one of the taper completers were continued on low-dose maintenance. Conclusion: Community-based Suboxone taper-to-low-dose-maintenance is feasible and effective as an initial treatment for PO-dependence in remote First Nations populations, although abstinence is difficult to achieve and longer term maintenance may be required. More research on OST for First Nations people is needed; existing OST options, however, should be made available to First Nations communities given the acute need for treatment. Article in Journal/Newspaper First Nations University of Toronto: Journal Publishing Services |
institution |
Open Polar |
collection |
University of Toronto: Journal Publishing Services |
op_collection_id |
ftunitorontoojs |
language |
English |
topic |
Aboriginal health addiction community-based treatment prescription opioids opioid substitution treatment |
spellingShingle |
Aboriginal health addiction community-based treatment prescription opioids opioid substitution treatment Katt, Mae Chase, Claudette Samokhvalov, Andriy V. Argento, Elena Rehm, Jürgen Fischer, Benedikt Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
topic_facet |
Aboriginal health addiction community-based treatment prescription opioids opioid substitution treatment |
description |
Objective: Non-medical prescription opioid use (NMPOU) is a major health problem in North America and increasingly prevalent among First Nations people. More than 50% of many Nishnawbe Aski Nation communities in northern Ontario report NMPOU, resulting in extensive health and social problems. Opioid substitution therapy (OST) is the most effective treatment for opioid dependence yet is unavailable in remote First Nations communities. Suboxone (buprenorphine and naloxone) specifically has reasonably good treatment outcomes for prescription opioid (PO) dependence. A pilot study examining the feasibility and outcomes of a community-based Suboxone taper-to-low-dose-maintenance program for PO-dependent adults was conducted in a small NAN community as a treatment option for this particular setting.Design: Participants (N = 22, ages 16–48 years) were gradually stabilized on and tapered off Suboxone (provided on an outpatient and directly-observed basis) over a 30-day period. Low dose maintenance was offered post-taper to patients with continued craving and relapse risk; community-based aftercare was provided to all participants. Results: Of 22 participants, 21 (95%) completed the taper phase of the program. Fifteen (88%) of 17 participants tested by urine toxicology screening had no evidence of PO use on day 30. No adverse side effects were observed. All but one of the taper completers were continued on low-dose maintenance. Conclusion: Community-based Suboxone taper-to-low-dose-maintenance is feasible and effective as an initial treatment for PO-dependence in remote First Nations populations, although abstinence is difficult to achieve and longer term maintenance may be required. More research on OST for First Nations people is needed; existing OST options, however, should be made available to First Nations communities given the acute need for treatment. |
format |
Article in Journal/Newspaper |
author |
Katt, Mae Chase, Claudette Samokhvalov, Andriy V. Argento, Elena Rehm, Jürgen Fischer, Benedikt |
author_facet |
Katt, Mae Chase, Claudette Samokhvalov, Andriy V. Argento, Elena Rehm, Jürgen Fischer, Benedikt |
author_sort |
Katt, Mae |
title |
Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
title_short |
Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
title_full |
Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
title_fullStr |
Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
title_full_unstemmed |
Feasibility and Outcomes of a Community-Based Taper-to-Low- Dose-Maintenance Suboxone Treatment Program for Prescription Opioid Dependence in a Remote First Nations Community in Northern Ontario |
title_sort |
feasibility and outcomes of a community-based taper-to-low- dose-maintenance suboxone treatment program for prescription opioid dependence in a remote first nations community in northern ontario |
publisher |
Waakebiness-Bryce Institute for Indigenous Health |
publishDate |
2013 |
url |
https://jps.library.utoronto.ca/index.php/ijih/article/view/29021 https://doi.org/10.3138/ijih.v9i1.29021 |
genre |
First Nations |
genre_facet |
First Nations |
op_source |
International Journal of Indigenous Health; Vol 9 No 1 (2012): Journal of Aboriginal Health; 52-59 2291-9376 2291-9368 10.3138/ijih.v9i1 |
op_relation |
https://jps.library.utoronto.ca/index.php/ijih/article/view/29021/23838 https://jps.library.utoronto.ca/index.php/ijih/article/view/29021 doi:10.3138/ijih.v9i1.29021 |
op_rights |
Copyright (c) 2017 International Journal of Indigenous Health |
op_doi |
https://doi.org/10.3138/ijih.v9i1.29021 https://doi.org/10.3138/ijih.v9i1 |
_version_ |
1766000607110365184 |